There is growing recognition that global health needs sound female leadership now more than ever. The Generation Equality Forum culminated in Paris and coincided with a poignant time, during which the disproportionate impact of the COVID-19 pandemic on women and girls has been made evident. As Executive Director of UN Women, Phumzile Mlambo-Ngcuka, said: “The Generation Equality Forum marks a positive, historic shift in power and perspective.”

The pandemic allowed many inequities to surface; among them, the gendered nature of leadership. Despite some of the most successful leaders during the pandemic being women, guiding their countries to safety and security, the number of female leaders in such positions of power remains abysmally low. In the global health field, women account for only a quarter of leadership positions despite making up 70 percent of the workforce. Yet, gender-related gaps in leadership remain wide. The time estimated for the gender gap to close grew by 36 years in the span of just 12 months, according to the World Economic Forum’s 2021 Global Gender Gap Report. This report now predicts that it will take approximately 135.6 years for women and men to reach parity on a range of factors worldwide, instead of the 99.5 years outlined in the 2020 report. However, women from the Global South are very poorly represented in global health leadership positions, and diversity and inclusion remain a lofty dream. Women from low- and middle-income countries (LMICs) are strongly underrepresented as researchers, academics, authors, and experts in global health leadership positions across health sectors. They remain a silenced voice and the silence is deafening. These gender-related gaps are ironic, since some studies show that women can perform better than men in leadership positions during times of crisis. Many women engage better with the communities they serve, naturally prioritise women and child health, pay attention to marginalised groups, and don't take away attention from reproductive health and sexual health even when resources are scant. Consequently, when women lead, women are taken care of, men become allies, and outcomes improve for everyone.

Yet women from the Global South face more hardship when trying to rise in power or retain their power. Leadership training opportunities are scarce and unavailable locally. Moreover, the road to leadership is barely shared and challenges are steep—seeped in patriarchy, hierarchy, and bias. There may also be a lack of support systems for women like peers, coaches, mentors, role models, champions, and other support structures.

Building leadership for women from the Global South will require the following:

• The concerted effort of many—including those from governments, civil society, the private sector, entrepreneurs, academia, and social influencers—to drive urgent action and accountability for gender equality. These sectors have to nominate, elect, promote and support women to take on leadership positions and be authentic about it—not tokenistic or charitable.

• Investment in the form of skill building, knowledge translation, mentorship, supportive supervision, champions, role models, peer support systems, fellowships, scholarships, and sponsorships. More women need to be in the boardroom, at the table, with a mic, and have a chance to speak and be addressed by their title.

• The ally-ship of men. It will take people of all genders to encourage positive change. Men can acknowledge their privilege, be more open about their support for female leaders, lean out more to make space for women to lean in, be sensitive to gender bias, and be explicit about ameliorating it. Gender equality and promoting women’s leadership will only be achieved when everyone works together.

• Finally, it will take concrete and authentic commitment with clear goals and strategies to create gender parity in global health leadership, and involves deliberately encouraging and supporting women leaders from the Global South as we seek to re-imagine global health. Now more than ever, we need sound leadership, and if that comes from women, from the world over, it’s a win-win. When women lead, good health follows.

The long road to leadership should be enabling, collaborative, and inclusive of all, especially women from the Global South.